Individual
JOHN THOMAS MCDONNOLD II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2455 CLAY CREEK RD, BRENHAM, TX 77833-6328
(979) 251-8210
Mailing address
2455 CLAY CREEK RD, BRENHAM, TX 77833-6328
(979) 251-8210
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J1310
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8K2682
MEDICARE INDIVIDUAL PTAN STERLING HEALTHCARE SERVICES ST MARKS MEDICAL CENTER
TX
Enumeration date
10/25/2007
Last updated
05/05/2008
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